World Business Times INSIGHT: The State of Qatar
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Master mind A knowledge-based economy is key to Qatar’s future
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Bringing down the ‘Big C’ The Qatar Cancer Society is on a mission to stamp out cancer
The State of Qatar WORLD BUSINESS TIMES INSIGHT REPORT DISTRIBUTED BY THE DAILY TELEGRAPH
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n a few short decades, hydrocarbon wealth has transformed Qatar from a tiny Gulf state heavily reliant on pearl diving into the richest per capita population on the planet. Now, that same liquid gold is causing the country to reassess its fiscal health, but thanks to years of prudent planning analysts predict minimal impact. The country remains one of the fastest growing in the region and the International Monetary Fund (IMF) says Qatar’s near-term macroeconomic outlook remains strong. The opening of a new natural gas field and continuation of its public infrastructure program – worth up to $200 billion – may even see gross domestic product (GDP) growth rise from 4 per cent last year to 4.5 per cent in 2015, according to the IMF. Qatar National Bank (QNB) said in its December 9 report that it expects real GDP growth to average 4.7 per cent in 2015. Importantly, the growth is being fuelled by the non-hydrocarbon sector (10.4 per cent) – principally investment spending and population growth. The hydrocarbon sector is expected to slightly contract (-0.5 per cent). The saviour here is Qatar’s tremendous fiscal power. Qatar has amassed more than $45 billion in fiscal reserves, according to QNB. Those reserves, however, have been shrinking amid lower oil and gas prices. The current account surplus narrowed to $4.7bn (11.1 per cent of GDP) in Q2 2015, according to QNB, which expects it to shrink further to 6.2 per cent of GDP in 2015, before stabilising in 2016/17. The sobering forecast is particularly impacting the country’s banking sector, with liquidity drying up, Moody’s analyst Khalid Howlader warned. “The Qatari economy still has a relatively high growth trajectory but with a high dependence on declining government deposits, coupled with new regulations requiring banks to limit their LDRs (loanto-debt ratios) to 100 per cent, liquidity is definitely tighter and commensurately more expensive,” he said. The banking sector is expected to further heat up as the Central Bank approves licences for 10 GCC banks to operate in the country, potentially forcing the least cost-efficient out of the market. At least four Qatari banks are reportedly rearranging new financing to compensate. But Qatar Central Bank governor Sheikh Abdulla Bin Saoud Al Thani insisted strong macroeconomic fundamentals would support healthy growth in the banking sector.
Fiscal finesse
Qatar’s financial institutions are facing difficult decisions amid prolonged low oil and gas prices but the country’s strong reserves are helping to buffer the damage. Sarah Livingstone reports.
Qatar remains one of the fastest growing country’s in the region with a strong near-term macroeconomic outlook
Banks’ balance sheets have grown accumulatively more than 10 per cent in the past two years and remained “highly profitable”, with a return on assets of 2 per cent, Sheikh Abdulla said. They had a non-performing loan ratio of less than 2 per cent and sufficient capital buffers to cover potential adverse developments. In any case, the Central Bank has been strengthening market infrastructure, implementing Basel III provisions, a more sophisticated and secure bank transfer system, developing the government and corporate debt market, broadening the investor base in the primary and secondary markets and introducing a deposit protection regime. “Hence, we expect the banks to continue to grow at a healthy pace, with stronger fundamentals in terms of profitability, quality of assets, capital buffers and risk management,” Sheikh Abdulla added. Qatar’s enhanced financial system was recognised last year with the country’s upgrade to emerging market status by
leading rating agencies, providing access to $1.5 trillion of funds that are benchmarked against the MSCI emerging markets index. “We expect all these measures would enhance the confidence of the potential investors,” Sheikh Abdulla said. Private sector investment and diversification from hydrocarbons are being vehemently pursued to sustain growth momentum amid the current global economic environment. The awarding of the right to host the FIFA World Cup in 2022 had already spurred significant expansion of infrastructure, while a 40 per cent growth in population since 2010 has seen more schools, residences, hospitals, retail outlets and hotels, all of which are stimulating the non-hydrocarbon economy. The new Hamad International Airport and a 26.5km2 port, expected to open next year, will also have a significant impact. Moody’s Howlader said Qatar had already made “some reasonable diversification progress”, with the hydrocarbon sector’s contribution to government revenues declining from about
Buoyancy in a tough
historically low oil prices, intensified militant activity and the re-emergence of Iran, writes Senior Advisor for
the country into overdrive towards the 2022 FIFA World Cup and its related infrastructure, plus the development of the Doha metro system and the emerging industrial hubs in South Doha, which will provide greater opportunities in sectors as broad as food, construction, manufacturing, fashion and electronics. According to the Qatari Ministry of Development Planning and Statistics, despite the decline in international oil prices, Qatar’s economic growth will remain robust at 7.3 per cent by the end
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December 20, 2015 locally listed firms, while the regulatory system discriminates in favour of Qatari and GCC-owned businesses. Opening up foreign investment will be crucial to foster a vibrant SME sector, which currently accounts for barely 10 per cent of GDP. Sheikh Abdulla said Qatar was gradually conforming to international standards; QCB has been moving to risk-based regulation, expanding macro-prudential oversight, enhancing transparency, strengthening market infrastructure, and improving consumer and investor protection. The establishment of Qatar as the first regional Renminbi clearing centre also augured well for further development of the financial sector and trade with Asia, particularly China. “This, along with benign inflation, a strong credit rating and a favourable tax regime, will continue to make Qatar a preferred investment destination,” Sheikh Abdulla argued. “Qatar Central Bank has been undertaking prudent liquidity management operations to ensure that overall liquidity in the system remains consistent with the growth and inflation objectives and will continue doing so going forward.” As well as attracting greater FDI, IHS Middle East senior economist Ana Melica argued subsidy reform, containing wage growth and promoting private sector employment must be short-term priorities. The IMF estimates that eliminating energy and water subsidies could save about 1 per cent of non-hydrocarbon GDP. “Eliminating those subsidies alone could potentially close the expected fiscal deficit,” Melica said. CEO of Qatar-based asset management firm Amwal, Fahmi Aghussein, said the government also needed to carefully balance public spending cuts amid lower hydrocarbon revenues. “The main priority will continue to be how to keep providing social services – healthcare, education, the meaningful things to the average Qatari citizen. That also includes creating jobs, wealth and opportunities so that they can benefit for the next 50 years,” he said. While change is inevitable, Qatar’s strong financial starting point allows for gradual implementation, minimising adverse ramifications for both the population and businesses. Just as Qatar has reinvented itself over the past halfcentury, it will undoubtedly do so again. And, as the discoveries of pearls and then hydrocarbons transformed the nation, what lies around the corner under Qatar’s new strategy may well be another gem.
The world is opening up to Islamic finance as even the West gradually recognises its benefits, as Sarah Livingstone explains.
Strong leadership is helping Qatar stay afloat amid
QATAR continues to amaze outside observers with Doha’s ability to weather a number of different storms: the gloomier economic environment brought about by lower oil and gas prices; wars being waged in the Levant, Libya, Egypt and Yemen, as well as terrorist attacks in neighbouring Saudi Arabia and Kuwait; and the unfolding role of Iran in the global economy when sanctions are lifted in 2016. The Gulf state’s economy is an important driver. The Qatari Development Plans for 2022 and 2030 are pushing
85 per cent to 65 per cent since 2000. “A lot of the diversification has been in construction and real estate and the FIFA World Cup 2022 will provide a nondiscretionary anchor for infrastructure investment and hence supports non-oil related growth,” he said. However, IHS warns diversification in the Gulf state will be a “slow process”.
The Gulf state pours billions into an urban makeover
Unconventional money maker
neighbourhood Gulf State Analytics, Dr Theodore Karasik.
Qatar Central Bank Governor Sheikh Abdulla Bin Saoud Al Thani
It does not expect a structural shift away from energy dependence for at least five to seven years. There also remains plenty of scope for improvement to Qatar’s business environment, for both international investors and small to medium-sized enterprises (SMEs). The IMF has suggested more needs to be done to simplify business registration, improve enforcement of contracts, enhance the quality of education, privatise some public assets to stimulate the private sector and labour market reforms. While Qatar has low taxes and one of the easiest tax compliance regulations in the world, excessive bureaucracy, nepotism, tight turnaround times and changes to project specifications commonly cause delays to projects and raise the risk of contractual disputes and cancellations, according to IHS. Unlike in the UAE, which has about a dozen free trade zones, foreign investors have little opportunity for full ownership in Qatar and are limited to 49 per cent of
Billion-dollar building ground
Qatar’s Emir, Sheikh Tamim bin Hamad Al Thani
of 2015. By comparison, the UAE has downgraded its GDP growth for 2015 to 3 per cent from 3.5 per cent. But as the pace of investment activity in non-hydrocarbon sectors begins to taper, and population growth recedes, GDP growth will moderate to 6.6 per cent in 2016 and 6 per cent in 2017. On the fiscal side, the overall balance is expected to narrow in 2015, given lower oil and gas revenues
ONCE steeped in mystery for the majority of the world, Islamic banking is becoming increasingly popular among governments, companies and investors worldwide. Its growth far outpaces that of conventional banking, at about 10 to 12 per cent annually, according to the World Bank. The International Monetary Fund (IMF) has even suggested Islamic banking products could prove safer than conventional instruments, due to their no-interest rules that instead typically mean the lender holds full or partial ownership of the asset against which the loan has been taken out. Globally, there are about $2 billion worth of Shariah-compliant financial assets, according to the World Bank, while the UK-based Islamic Finance
and Sukuk Company estimates the entire market (including banking) is worth between $1.66 to $2.1 trillion, rising to $3.4 trillion by the end of 2018. Islamic finance is also gaining traction amongst conventional institutions, many of whom have created dedicated divisions, as well as in nonIslamic countries. The UK became the first Western country to issue a sovereign Sukuk in June 2014. It was ten-times oversubscribed. Tamim Hamad Al-Kawari, Chief Executive Officer at Qatar-based QInvest, said Islamic bonds (also known as Sukuk), were increasingly popular because they allowed companies and governments access to a different class of investors.
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They also provided issuers with access to Islamic investors – many of whom have accumulated vast amounts of wealth in the oil and gas bonanza of the past half-century – and gave Islamic banks an opportunity to generate returns on their excess liquidity. “Sukuk can match the same returns as conventional bonds and recent issuances have proven this,” Al-Kawari said. “For example, the Luxembourg sovereign Sukuk, which QInvest advised on, issued at a similar price to the equivalent bond. Similarly for the UK sovereign Sukuk and a number of corporate Sukuk, including Goldman Sachs [which raised $500m in its first Sukuk issuance last year].” Continued on page 2
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Qatar’s future will depend on how well it can generate a knowledge-based economy, Jennifer Bell writes.
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Unconventional money maker
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atar’s rapid ascent in recent decades may have been built on hydrocarbons wealth, but its long-term future will depend on a resource not at the mercy of global price fluctuations: knowledge. Enshrined in the Qatar National Vision 2030, the Gulf state is determined to transition to a knowledge-based economy, with science, research, innovation, entrepreneurship, and education as its cornerstones. The research and development arm of state-backed Qatar Foundation (QF R&D) is overseeing the implementation of this lofty goal. Under its stewardship, new research projects are being coordinated and partnerships formed nationally, regionally, and globally; Qatar-born intellectual property is being created, protected, and commercialised; innovation and technology start-ups are being supported; and initiatives are encouraging young Qataris to pursue careers in science. The Qatar National Research Fund has supported more than 1,000 research projects identified as having the potential to benefit Qatar, while research and enterprise are being nurtured within Qatar Science & Technology Park, a free zone housing hi-tech companies and entrepreneurs from around the world. Research institutions also have been established in the fields of cybersecurity, energy, the environment and biomedicine. QF R&D executive vice-president Hamad Al Ibrahim, said the initiatives were designed to create an “ecosystem” of research in Qatar. “The unique quality of technology and innovation is that they create undiminishing returns,” he said. “Ensuring a sustainable economy for Qatar requires focus and investment in these areas. “Transitioning to a knowledge-based economy is not an option; it is a destiny. The question is not whether we should diversify; it is how we can prepare ourselves to do so.” The definitive goals of QF R&D – part of Qatar Foundation, a non-profit organisation
Qinvest CEO, Tamim Hamad Al-Kawari
As the market gains extra momentum, Islamic banks are also becoming more innovative with their Shariah-compliant financing solutions. This is particularly evident in many Muslim oil exporting countries, with lower state deposits pressuring profits. The growth has set the scene for an Islamic finance race. Malaysia, UK and Saudi Arabia are already front runners according to various indices and Dubai has declared its intention to become the global hub of the Islamic economy, while Qatar is driving its market and Bahrain recently launched the first Islamic Index in the GCC. Turkey has been growing steadily with several new Islamic banking licenses and Kazakhstan has announced a new financial centre with Islamic finance as a key pillar. Even Europe, traditionally one of the international hearts of conventional banking, has established a fully-fledged Islamic bank in the UK, Rasmala (formerly the European Islamic Investment Bank). Reaching critical mass will be key for the development of the sector. But while it has matured, there remains sizeable reluctance to use Islamic banking products. For many, it is still misunderstood, while others argue it is more expensive than conventional finance and too difficult to implement. The IMF echoed the concerns in April when it warned that Islamic bankers must tighten their rules and improve consistency in their application. QInvest is working to help unveil some of the mystery surrounding Islamic finance, carrying out educational exercises for sovereigns and corporates. Al-Kawari said, while there was plenty of room for improvement, Islamic financial institutions were becoming increasingly sophisticated. “On implementation, some complexities still exist, primarily due to the additional structuring required. However, the increased deal flow has resulted in some standardisation with the implementation of transactions becoming much simpler,” Al-Kawari said. “Islamic finance has also become less expensive in recent years. As the industry has reached critical mass and become more competitive, the returns, yields and cost of funding have become much closer to conventional finance. We expect this trend to continue, particularly in the GCC, where the pricing of Islamic finance is competitive. In fact, sometimes it can now be less expensive than conventional finance. “We expect that both trends of standardisation and increased sophistication are set to continue and will attract more companies and investors into the Islamic finance sector.” Al-Kawari said in most cases, QInvest competed like-for-like with conventional institutions. “We have recently been working on deals in jurisdictions where other banks have been unable to navigate the legal and structural complexities and have been able to work as fast, if not faster than our conventional counter-parts,” he said. Some of the issues are also being ironed out by standard-setting bodies such as the Bahrain-based Accounting and Auditing Organisation for Islamic Financial Institutions (AAOIFI) and the Malaysiabased Islamic Financial Services Board (IFSB). As the sector grows, precedence are also bound to be set, strengthening it even further. With trillions of dollars on offer, more bankers are bound to get on board. SME Fund 154x85mm.pdf
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Master mind Qatar Science & Technology Park
spearheading initiatives in education, science, research and community development – include a national research analytics laboratory and integrated research and development plan. But there are also more intangible objectives. The value of research, Al Ibrahim said, must be intrinsic in Qatari society, with young people immersed in science from an early age, encouraged to take risks in order to innovate, and prepared to ultimately take the lead in a new economic world. “We have all the components of successful innovation, and all the factors that allow a nation to diversify to a knowledge-based economy,” he said. “We have a free zone where innovation is incubated and accelerated, interaction between researchers, and the resources, systems, and support to capture and mature ideas, develop them from concept to reality and produce tangible outcomes. We have the capacity to transform challenges into opportunities. “Now we must place all of these pieces into a single picture. Attract the best research minds to Qatar, integrate them into a society where research becomes a culture, not simply an activity, and ensure synergy between research, education and industry. By doing this we can create the vibrant
research ecosystem we aspire to create.” A pillar of support for this ecosystem is Qatar Business Incubation Center, whose aim is to develop Qatar’s next QR100m ($27.46m) value companies. With Qatari telecommunications firm Ooredoo, it has launched the Digital and Beyond incubator, intended as a catalyst for new start-ups and technology-focused businesses. A platform for Qatari entrepreneurs to bring their innovations to global attention and potentially Qatar’s own Silicon Valley. The development of a research culture is also increasingly reflected within Qatar’s education sector. Qatar University is tasked with conducting studies in areas including energy and environment, through collaboration with both the government and the private sector. Meanwhile Hamad bin Khalifa University, an emerging research institute, has established postgraduate programs focused on developing a pool of talent that can address Qatar’s greatest challenges. Other prestigious international universities that specialise in areas including health, engineering, ICT, media and communication, art and design, and executive education are being drawn to Qatar Foundation’s ‘multi-university’
project, Education City. The city is intended to broaden the country’s skill base, with graduates to be deployed across a range of fields, contributing to the knowledge-based economic diversity. “QF R&D is a long-term project with a longterm plan,” Al Ibrahim said. “Through our work in schools, we enable children to engage with science and math, participate in experiments, and ensure that, regardless of success and failure, their knowledge is enhanced. We are seeking to instil a mind-set of creativity and innovation at an early age and – in collaboration with the education system – bring about change in the culture of learning. “Across the whole spectrum of education, through our programs and initiatives, QF R&D is encouraging young people to develop the social attributes of accepting failure and of taking risks in order to innovate – attributes that represent the soft indicators and the intangible value of innovation. And we are empowering them to become leaders in research and development.” The tools are in place, the question now is how well they will be used. The response, as Qatar’s leaders have made clear, may define Qatar’s economic endgame.
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Buoyancy in a tough neighbourhood and large expenditure outlays. The International Monetary Fund (IMF) warns that in 2016, the fiscal balance may even register its first deficit in over 15 years. Minister of Development Planning and Statistics Saleh bin Mohammad Al Nabit said the government was working to attract more foreign direct investment to help boost the non-hydrocarbon sector. “Qatar needs foreign investors in non-oil and gas sectors. It is easy to invest in opportunities and options available,” he said. While the country is far from economic turmoil, Qatar’s Emir, Sheikh Tamim bin Hamad Al Thani, has warned citizens that the government can no longer “provide everything”. He has conceded that previously large government subsidies and benefits offered to its citizens had brought about a reduction in the “motivation of individuals to take initiative and be progressive” and that a sudden reduction in spending by the government would enable its citizens to “reject self-delusion”. This move emulates other announcements in Gulf Arab states that subsidies are or will be lifted to alleviate stress on state budgets. Without revealing exact figures, the Emir alluded to the notion that Qatar planned to refrain from double-digit increases in spending, which have been commonplace throughout the past 10 years. That step is a major adjustment in Qatar’s planned performance. On the foreign policy front, there are several notable aspects. Sheikh Tamim actively engages with his Gulf Cooperation Council (GCC) counterparts, particularly Saudi Arabia, and supports cohesiveness of the group, including in negotiations on disputes in Syria, Sudan, Libya, Gaza, and Lebanon. Throughout the past two and a half years, Sheikh Tamim has ensured that the thorniest of disputes have been carefully handled. His delicate diplomacy
has seen the country soften its approach towards some contentious issues, particularly relating to its perceived close relationship with some militant groups outlawed by other GCC members. Nevertheless, Qatar has pushed hard on regional fronts. It is providing financial support and weaponry to Jaish al-Fatah and other militant groups in Syria, and reportedly donated $1.22 billion to Sudan in return for on-the-ground troops to help the Saudi-led coalition in Yemen. Doha is also working both unilaterally and in cooperation with the United Nations to negotiate on-the-ground agreements in Libya, including a recently concluded settlement between the Tebu and Tuareg tribes in the southwest part of the country. The United States, with whom Qatar has a strategic partnership, and other European countries, such as the UK and France, appear to support Qatar’s overall approach. Meanwhile, Sheikh Tamim has a strong working relationship with Saudi King Salman and his son, Deputy Crown Prince Mohammed bin Salman, particularly in the political arena. The countries’ alliance has strengthened since Saudi Arabia, under the late King Abdullah, withdrew its ambassador from Doha in March last year. Although some other Arab countries are extremely unhappy with their budding relationship, it is notable that both Qatar and the kingdom are now coordinating their diplomatic credentials in Syria and Afghanistan. It is their bilateral relationship that helps Doha act as a go-between in hostage negotiations from the Levant to Kabul, negotiating with Al Qaeda’s Al Nusra Front and the Taliban for the release of Lebanese and Western hostages, including American Bowe Bergdahl and the potential for Saudi Arabia to act on behalf of Syrian opposition groups set on forcing Syrian President Bashir Al Assad
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THE Qatar Financial Centre (QFC) recently received a very welcome accolade when global credit rating agency Moody’s named Qatar the fastest-growing insurance market in the GCC achieving the third largest premium volume in 2015. Recent public policy changes made at top government levels in order to make Qatar a more attractive work place for expatriates have created a great opportunity for investment in the sector. One company that was expressly set up to take advantage of such opportunities and has done so in spades is Seib Insurance & Reinsurance – formed just six years ago, but now an exemplar of how a start-up can quickly rise through the ranks to become a key player in a sector of serious potential for Qatar – the healthcare insurance sector. “Qatar’s mandatory health insurance
out of power. Clearly, Wahhabist ties do indeed bind between Doha and Riyadh. Where real trouble potentially lies for Doha, however, is with outside perceptions that it harbours and supports the Muslim Brotherhood, which is considered a terrorist organisation by countries including the UAE and Saudi Arabia. Qatari officials, including Foreign Minister Khalid Al Attiyah, deny the allegations, while also professing to be a potential political broker in fixing the region’s contagion. Finally, one cannot write about Qatar without talking about Iran’s emergence from sanctions. Sheikh Tamim and his coterie are well aware of Tehran’s plans; Qatar was one of the first countries to welcome the Joint Comprehensive Plan of Action. “The relations between Doha and Tehran are evolving and growing steadily, based on common interests and good neighbourliness,” he said. Doha understands Iran’s future economic potential, given the shared Pars gas field in the Gulf as well as Qatar’s vision to help the Islamic Republic integrate gas projects. Qatar Airways is also helping to open up Iran’s commercial aviation sector to the outside world. It is clear that Qatar is navigating the treacherous waters of the Middle East with a firm hand. That grip helps Doha remain balanced and positive in the region’s choppy seas. The outlook, given Qatar’s unique geography and alliances with the West, is relatively positive, as long as the Emir does not make a tactical internal or external policy mistake. In the coming years, the neighbourhood will be going through more dramatic changes that will challenge Qatar and its role in the region in new and unique ways. But it is evident the current leadership is ready to face them.
Market shaper Seib Insurance & Reinsurance has risen to dominate one of Qatar’s most promising sectors in just six years. program for expatriates is a social as well as an economic responsibility.” Says Seib’s Deputy CEO and COO Elias Chedid. “Translating such a program into success for our company required four central elements: The first, is a coherent and well balanced regulatory platform covering private institutions, healthcare providers and insurers. The second, is a successful track record in large account management by those insurers providing the services; Third is the readiness of healthcare providers in terms of capacity and medical
expertise across the entire healthcare segment; which the Qatar government has been actively promoting and investing in for over a decade. Following is the readiness of employers to meet the financial and administrative requirements of the law. For this element to materialise, regulatory monitoring is essential, again something that the Qatar authorities excel at.” Seib is one more example of how the correct policies backed up by top class regulations are helping Qatar achieve its goal to further diversify its economy.
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Bringing down the ‘Big C’ The Qatar Cancer Society is facing an uphill battle against one of the biggest causes of death in the country. Founder Dr Khalid Bin Jabor Al Thani talks initiatives, obstacles, and why citizens must act now to stamp out cancer.
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here’s a man on a mission in Qatar, and his name is Dr Khalid Bin Jabor Al Thani. His task? Eliminate cancer in the long run, and in the meantime, provide access to treatment for the citizens of Qatar. This desire has resulted in establishing a vital venue for both Qataris and expats who have been diagnosed with cancer: the Qatar Cancer Society (QCS). Founded in 1997, the QCS offers physical, psychological, and financial support for those diagnosed. Additionally, it’s a place to educate – to find answers and solutions concerning the hazy, often terrifying disease.
Cancer is the third highest cause of death in the Gulf state, with the number of people diagnosed with the disease rising significantly. The QCS has had substantial impact since its establishment seven years ago but Dr Khalid, one of three founders, has lifechanging plans for the years to come. Cancer causes more than 8.2 million deaths worldwide each year, according to the World Health Organization (WHO). In Qatar, 12 per cent of deaths are attributable to cancer annually. The country struggles most fervently with colorectal cancer (also known as colon cancer) among males and breast cancer among females. However, at least one-third of cancer cases are preventable, according to WHO, whose cancer country profile reveals the top adult risk factors for contracting the disease are a combination of physical inactivity and obesity. QCS is focusing much of its attention on preventing these detrimental lifestyle habits. Dr Khalid, who has personally struggled with weight gain and maintaining consistent exercise, advocates for the effectiveness of promoting early awareness for children and teens. “People talk about awareness as if it’s just about education, but it’s not just education: Awareness is a change in complete lifestyle… Cancer awareness must start at a very young age,” he said. This urgency to increase the detection rate early-on is due to the disparity between non-Qataris who are required by their employers to
Cancer is the third highest cause of death in Qatar and the number of people diagnosed has increased significantly
have routine check-ups, versus Qataris who, although are fully covered by the government, must overcome cultural stigma to seek check-ups and treatments on a regular basis. “QCS is very proud to say we take care of non-Qataris who cannot afford treatment, as citizens are covered by the government,” he said. Dr Khalid claims there is no waiting list at the QCS – a major statement from any cancer-associated centre, with delayed access to doctors a notorious problem on an international scale. However, the treatment process is still lengthy, as each case can be vastly different depending on the type of cancer, stage of diagnosis, and availability of staff. Among procedural drawbacks, Qatar continues to grasp for clear data surrounding the population of those diagnosed with cancer. Dr Khalid explains why the country’s high level of expats causes the data to be fragmented. “Unfortunately, we lose a lot of expats once they find out they have cancer. Often they go back to their country of origin by choice or they are terminated by their companies,” he said. “So looking at statistics, there is a big gap because we don’t know the mortality rate of these expats once they leave, as they’re no longer part of the system.” Beyond the lack of clear data, a myriad of obstacles exist for Qatar. Dr Khalid openly states the shortcomings of the QCS from an international standpoint, stating the quality of services provided is nowhere near its pinnacle potential. In 2011, the National Cancer Strategy: The Path to Excellence, backed by Sheikha Moza Bint Nasser, Vice Chairperson of the Supreme Council of Health (SCH), received QR2.204 billion ($610m) of funding and was officially launched.
Four years later, the initiatives have yet to pack the punch originally envisioned, Dr Khalid said. Slow initiation combined with a lack of services put the National Cancer Strategy behind schedule in achieving its goals, which included the refurbishment
Founder and Chairman of the Qatar Cancer Society, Dr Khalid Bin Jabor Al Thani
of the Al Amal Hospital, now known as the National Cancer Centre. With such a mass investment, how have the online services remained so out-dated? Why is access to initial information and early detection so ambiguous? Bound by rules, regulations, and bureaucracy, the pace of any governmental organisation will experience delay. When it comes to cancer, time has never been more of the essence. “The early detection program is there, but it is quite weak. I think it should be much better, it could have been better, but I think over the next five to 10 years it will drastically improve,” Dr Khalid said. So how will the QCS drastically spike the awareness needed among the nation’s youth? Dr Khalid plans
Cancer facts ■ Middle Eastern countries experience a lower rate of colorectal cancer and lung cancer than Europe or North America. ■ The GCC has the same range of GDP as Europe, $14,000 to 32,000 Purchasing Power Parity per capita, making cancer medication much more accessible in the GCC.
to launch an initiative for students to create art in order to bring awareness of cancer to the forefront of Qatar’s cultural narrative via poetry, essays, and short stories. Providing prize money up to QR500,000 ($137.3m), he hopes this incentive will inspire students to learn about cancer prevention long before previous generations past. Other initiatives include cancer training centres, which QCS is in the final stage of developing. Titled the Ooredoo Training Center, it is an effort to train, educate, and empower students aged from middle school to university level. However, the key focus for Dr Khalid is the incorporation of more Qatari women and citizens into the programs, as they are specifically aimed at transitioning young females to trainers. “This training will make a big difference in the reduction of cancer and a certificate from the cancer training centre would be a true achievement,” Dr Khalid said. “Working with women, it’s something that will make them believe in themselves, so they’re a proud member of the QCS, and that they can learn a lot about cancer.” From a cultural perspective, Dr Khalid is addressing the traditional Qatari role for women, which often means a wife or mother will be slow, even reluctant, to seek vital check-ups. This is a result of women focusing on the needs of men, a detrimental tendency as women’s mortality rate is much higher than men in Qatar. “We are focused on young women because we as men can be selfish,” Dr Khalid said. “Many times men can be demanding, and a woman by virtue of being a mother will focus on her husband, her son, her brother, her father, etc. We’re shifting that culture, slowly.” Dr Khalid added society must
change its cultural expectations of women, who are typically put second to men. Such a profound need for evolution is a result of grim statistics surrounding breast cancer. According to WHO, mammograms (the x-ray image used to screen signs of breast cancer) are “not generally available at the public primary health care level”, despite the fact that breast palpation/clinical breast exams (CBE) are considered “generally available”. “When looking at mortality rates of breast cancer in this part of the world, women most at risk are in their 30s and 40s; whereas women in the US and Europe are typically in their late 50s and early 60s,” Dr Khalid said. “Breast cancer at a later stage of life can be easier to treat, which is why we are working very hard to change the nation’s awareness surrounding early detection.” The entire nation must examine their relationship with exercise, food, and a sedentary lifestyle linked to obesity, Dr Khalid also warned. Fifteen years ago, the cancer incidence rate in Western countries was 450 cases per a population of 100,000, where the GCC experienced 92 to 96 per a population of 100,000. Today, the West has managed to reduce cancer cases to around 200 to 220 per 100,000 while the GCC is seeing an increase to 140 to 150 per 100,000. Improved technology, accessible facilities and high-tech treatments are all available in Qatar, so what has gone wrong? Why aren’t the numbers reflecting decreased cancer cases with all the rich resources made available? Dr Khalid partly blames the recent generations’ adoption of a sterotypical Westernised relationship with food, entertainment, and an overall lack of physical activity. “The lifestyle has definitely
changed in the last 20 years. And the number of young obese that I can see is unbelievable,” he said. “Sedentary lifestyle is one of the main factors that I’m really concerned about. People can barely do things for themselves, therefore these areas also need to be addressed and I think we need to have a collaborative approach between education, healthcare and sports authorities.” However, the solution to this harmful way of life is not far off. Despite the national shift towards sedentary habits, the trend to stay in shape for physical purposes, and the push to eat organic and ‘clean’ whole foods is simultaneously popularising. The learning process is cyclical and ongoing. “I believe in 20 years from now this [sedentary lifestyle] will be history for the citizens of Qatar,” Dr Khalid said. “We can see a shift in young people training every day, trying to improve their physical appearance, taking care of themselves: it is part of the education process. We also need to look at how cancer is being written about – there are a lot of misinformed people.” One in every three cases of cancer is preventable, whether from tobacco (a major staple to the culture of Qatar via cigarettes and hookah), alcohol, lack of exercise, and/or diet. In a short period of time, specifically within five years to a decade, this information should be made widely known to the population. Widespread knowledge will be key for minimising cases of cancer, but Dr Khalid also suggested each Gulf nation needed to become a hub of excellence in various forms of cancer treatment. Saudi Arabia already had a strong positioning in curing breast cancer, while Qatar’s own specialty in preventing colon cancer was an example of how each nation could specialise, he said. Rather than a range of Gulf countries attempting to excel in a variety of treatments, diversifying the Gulf will allow both Arabs and expats to receive regional top tier care. QCS has the freedom to excel at what the organisation sees fit, Dr Khalid said. “QCS has more flexibility of delivering the message for a very simple reason: it’s a non-government organisation and it’s not bound by rules and regulations that other institutions have to follow.” Although certain nations like Bahrain, UAE, and Saudi Arabia all have established cancer societies, Dr Khalid envisions a workforce made up by Qataris to serve the nation and eventually wipe the disease off the map, in partnership with independent supporters of the QCS and the government of the nation. “We have enormous support from the government, as well as public donations. I believe that has all helped the QCS,” Dr Khalid said. With such support and direction, the diagnosis for cancer in Qatar is looking far healthier.
Qatar Cancer Care objectives ■ Overall awareness of cancer and ways of prevention as widely as possible. ■ Financial support for cancer patients who are unable to afford treatment.
■ According to the World Health Organization’s (WHO) health care ranking, United Arab Emirates, Saudi Arabia, Bahrain, Kuwait, Oman and Qatar all have health outcomes in parity with or approaching those of other high income economies.
■ Coordinate with various stakeholders and monitor developments in other countries.
■ Only 21% of the world’s population is covered by population-based cancer registries, with particularly sparse registration coverage in Asia (8% of the total population) and in Africa (11%).
■ Encourage scientific methods by supporting research and studies and monitor the latest treatment methods to cope with this disease.
■ An average of 25% of total health spending in the region (GCC) is on cancer treatment pharmaceuticals.
■ Present the necessary recommendations and plans for raising awareness of the disease and its prevention.
■ Organise seminars, training courses and conferences.
4 QATAR
December 20, 2015
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Billion-dollar supreme Health reigns Qatar’s health authority is promising worldclass medical facilities with full access. But, as Elizabeth Wentling reports, it will require international investors.
THE Supreme Council of Health (SCH) has spent years preparing Qatar to become desirable for international investors. Today, they’re poised as ever for an inflow of partnerships that will provide high quality healthcare services. After experiencing the world’s fastest population growth within a decade (2000 to 2010), it is at a pinnacle moment to establish future affiliations. The UK’s General Medical Council, the Royal College of Canada International and the International Association of Medical Regulatory Authorities are already on board. SCH is also conducting research in collaboration with Harvard Qatar Minister of Public Health, University and the London School of Abdulla bin Khalid Al-Qahtani Economics and Political Science. The collaborations have seen dramatic improvement in the Gulf state’s For example, the SCH outsources to healthcare, said Dr Faleh Mohammed the private sector for specialised onsite Hussein, Assistant Secretary General facilities for migrant workers, a major for Policy Affairs at SCH and CEO of portion of the population. the National Health Insurance Company Meanwhile, the SCH and its public (NHIC) that oversees Seha, the first social healthcare providers have 73 new healthcare program in the GCC. facilities and 45 renovation projects under “Rapidly-changing lifestyles have construction, all while seeking private required a shift in care. Despite having partnerships to operate new healthcare the world’s second smallest proportion centres and hospitals specialising in blueof people over 65, we have non- collar migrant health. communicable disease rates similar to Dr Hussein said both private and ageing populations,” Dr Hussein said. public partnerships were being sought. “Cancer, diabetes and heart disease “There are several pieces of land in account for 43 per cent of known causes the private sector that the SCH have been of death. This requires a shift to enhanced given the opportunity to go in, invest, and prevention, promotion and primary care.” build hospitals and medical facilities on,” These same entitlements will be he said. extended to all non-citizens by the end The SCH’s Qatar Healthcare Facility of 2016 thanks to a major program called Master Plan 2013-2033 is an example of the National Health Strategy (NHS) the effort to support the private sector. It is 2011 to 2016 – an initiative considered the country’s first healthcare infrastructure the first step taken towards the Qatar investment guiding tool that identifies National Vision 2030 goals. Only associated market gaps. It presents one critical year is left for the NHS to numbers, locations, and illustrative costs attain its projected reforms, posing for hospitals, primary health care centres, the question: does it benefit the pharmacies, and major medical equipment population? Many of the 38 projects required up to 2033. The SCH and the proposed within the NHS stood at Qatar Council for Healthcare Practitioners 70 per cent complete in September have improved and automated licensing 2015, and strategies on cancer research, processes, leading to significantly shorter mental health, primary care, and professional licensing times. laboratories are still being carried out. The sector is poised for significant Initiatives within the private sector and rapid growth that should bode well Qinvest future_15.4x17_20151004.pdf 1 10/4/15 are also instrumental to development. for a healthy future for10:22 Qatar.AM
building ground
A new rail network, hotels and roads are part of the major infrastructure projects under way as the wealthy Gulf state pours billions into an urban makeover, writes Jennifer Bell.
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sk for an infrastructural snapshot of Qatar, and it is entirely possible that you will be told: “It’ll be great… when it’s finished”. In construction terms, Qatar – a nation which, as host of the 2022 FIFA World Cup, has a deadline for much of this finishing to be achieved – is driven by necessity as much as by ambition. Its hydrocarbon-propelled affluence and dramatic population growth has seen it come a long way in a short time. Now, in the build-up to one of the world’s greatest sporting showpieces coming to town, it is looking for a repeat performance. Qatar plans to spend up to $205 billion on infrastructure in the five years up to 2018, and while that figure was announced before oil prices began to nosedive, there will be little, if any, deviation from that strategy. Symbols of this seriousness are already in evidence. The $15.5bn Hamad International Airport, opened in 2014, and expansion plans for what Qatar hopes will become a global travel hub will see its annual passenger capacity – currently 30 million – rise to 53 million by 2020. Hamad Port – a $7.4bn project intended to free up Qatar’s supply chain for construction materials and drive down prices – has greeted its first ship, with its initial phase due to be completed by the end of 2016. The recent unveiling of the $631m Doha Exhibition and Convention Center, in Doha’s West Bay financial heartland, signifies Qatar’s ambition of cornering a larger slice of the international conference market. And to boost the private sector, 6.33m sqm of land has been earmarked for the nation’s biggest industrial and logistics center, comprising of offices, warehouses, showrooms, light industrial areas, service centres, and community facilities, in line with Qatar’s goal of positioning its economy to thrive in a post-oil and gas age. The World Cup has naturally accelerated Qatar’s
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sense of infrastructural urgency. Eight stadium locations are now confirmed, with the expectation of all venues being completed by 2020; Khalifa International Stadium – the Wembley of Qatar – will be the first, in late 2016. The tournament’s final is to be played in the new city of Lusail, perhaps the most ambitious, spectacular, and mysterious element of Qatar’s development agenda; currently a patch of desert north of Doha, it is intended to be a 38km2 metropolis of more than 200,000 people, and, if it lives up to its billing, ‘a city of the future’. Meanwhile, about 60 new hotels and serviced apartments are slated to open over the next five years, to meet unprecedented demand sparked by the World Cup and the intended rise in Qatar’s global profile. Key to making Doha a more fluid, less congested city is the Doha Metro, is Qatar Rail’s public transportation system. The initial phase of which is scheduled to become operational in 2019. It will have four lines, ultimately 107 stations, and the role of taking pressure off the city’s overworked roads. But public transport initiatives have not led to roads expenditure being rolled back: $13.7bn will be spent on new highways, drainage and other infrastructure across Qatar’s five regions – 200 projects
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Qatar Rail is building a futuristic rail network that will not only define what Qatar looks like for decades to come but will also create a more fluid and less congested Doha
A HOLIDAY in Qatar? Maybe not – yet. Business travellers currently account for two-thirds of total visitors to Qatar, but the Gulf state aims to more than double tourism figures to 7 million by 2030 by drawing them in with a diverse array of attractions from beach resorts to international sporting events and worldclass museums. Qatar is playing catch-up against some of its Arab neighbours, such as the UAE. Its own tourism strategy highlights the country’s lack of brand identity abroad, as well as its poor understanding of the potential opportunities in tourism. It also identifies the need to improve “relatively strict” entry barriers, inadequate regulations that are hindering growth and development and poor investment policies. But $8.5 billion worth of projects are intended to broaden the appeal, with a festival city, a new convention centre, a 45-hectare zoo, several cultural and art museums, libraries, theme parks and beach developments. A cruise tourism market will also be cultivated by renovating Doha Port when the new cargo port is completed, taking advantage of the country’s milder winter. Private and state developers are constructing about 60 hotels and resorts – mostly five-star – and 22 shopping venues, as well as six stadiums needed for the FIFA World Cup in 2022, which Qatar has won the rights to host, despite controversy. Even before the World Cup, Qatar has been forging a reputation for international sporting events including the 2019 World Championships in Athletics,
over seven years – with other key schemes including an expressway connecting West Bay and Lusail. Development of such scale, scope, and growth has already attracted, and will continue to attract, significant attention from international companies who see Qatar as a prime market opportunity. According to Dr Saleh bin Mohammed Al Nabit, Minister of Development, Planning and Statistics, infrastructure now represents a pivotal spoke in Qatar’s economic wheel. “We believe this growth will continue until 2020, and it will remain an active sector in terms of preparing infrastructure for future development and to accommodate future activities,” he explained. “There has been double-digit growth in the infrastructure sector over recent years. As that continues, we expect it to have more of a percentage stake in Qatar’s GDP in the years to come.” In its quest for global status and national sustainability, Qatar is undergoing its second great developmental transformation in the lifetime of many of its citizens, further illustrated by the Msheireb Downtown Doha, a $5.5bn mixed-use, 31-hectare scheme to regenerate the city’s traditional core. Within a decade, Qatar will become a very different place – again.
Sarah Livingstone looks at why Qatar is spending $8.5bn on projects as diverse as world-class museums and sporting stadiums in a bid to turn business visitors into holidaymakers.
Doha’s Museum of Islamic Art
the 2015 World Handball Championship, and annual international tennis, MotoGP and golf events. With a minimal sporting culture among the population, the sector will rely on tourists. Qatar is hinging much of its tourism success on cultural attractions, including the Museum of Islamic Art, the Arab Museum of Modern Art and the National Museum of Qatar. The country already has among the largest and most prestigious art collections in the world. The experience of nearby Dubai, the most open emirate in the Gulf, has seen Qatari tourism authorities pledge to remain “authentic” to the country’s culture and emphasise its “familyfriendly tourism” strategy. Many of the new visitors are expected to come from within the Gulf, which already accounts for at least 50 per cent more growth than outside the region, according to the Qatar Tourism Authority (QTA). Playing down competition with
neighbours, QTA chief tourism development officer Hassan Al Ibrahim said earlier this month Qatar would focus on Arabic culture and hospitality. “The secret in our region is that each of the destinations has different things to offer,” he said. The government expects tourism’s contribution to GDP to increase from less than 1 per cent in 2012 to 1.6 per cent by 2020, and tourist spend to rise from $1.3bn in 2012 to $11bn by 2030. Monthly hotel occupancy is already above 70 per cent, according to industry monitor STR Global, and QTA chairman Issa bin Mohammed Al Mohannadi has conceded the country will not meet the required number of hotel rooms for the World Cup. Cruise ships are expected to provide an additional 6,000 rooms and thousands of visitors are likely to commute from the UAE, which is less than an hour’s flight away. The new Hamad International Airport and Qatar Airways’ expansion are also pivotal drivers in tourism growth. The airport served a record 28 million passengers in its first year of operations (June 2014 to May 2015), a 23.6 per cent increase compared to the old airport. Growth momentum was maintained in the third quarter, with a record 8.4 million passengers. Additional taxiways are already being built, with $75m contracts announced in November, while Qatar Airways has been fast expanding with new destinations in the US, Europe and Australia. As more incentives are added to the tourism profile, the idea of a holiday in Qatar may not be so far away.